Emergency contraception (EC) can prevent pregnancy for women following unprotected sex or burst condoms etc. Most women who use EC in the UK go to a pharmacy for it. It is really important that women start a regular method of contraception after EC if they don’t want to become pregnant. However, most pharmacies cannot usually provide contraception (except condoms) without a prescription. This means that to start regular contraception (e.g. implant, pill etc) women must go to a GP or family planning clinic. Getting an appointment can take time and some women fall pregnant during this time.
BRIDGE-IT, funded by the NIHR HTA, was a cluster randomised crossover trial involving pharmacies in 3 UK regions - London (South and Central), Lothian and Tayside recruiting women aged 16 and over presenting for EC. In the intervention group, women received a 3 month supply of the progesterone only pill plus a rapid access card to a participating sexual and reproductive health clinic. In the control group, pharmacists advised women to attend their usual contraceptive provider. The primary outcome was use of effective contraception at 4 months.
636 women were recruited into the study, and 4 month follow-up data were available for 406 of these. At 4 months, the proportion of women using effective contraception was higher in the intervention group (mean 58·4%, 48·6–68·2), than in the control group (mean 40·5%, 29·7–51·3 [adjusted for recruitment period, treatment group, and centre]; p=0·011). No serious adverse events occurred. The study concluded that the provision of a supply of the progestogen-only pill with emergency contraception from a community pharmacist, along with an invitation to a sexual and reproductive health clinic, results in a clinically meaningful increase in subsequent use of effective contraception.
The BRIDGE-IT Trial was led by Dr Sharon Cameron based at the University of Edinburgh.
Contacts
- CHaRT email; chart@abdn.ac.uk
Status
CompletedPublications
Cameron ST, Baraitser P, Glasier A et al. Pragmatic cluster randomised cohort cross-over trial to determine the effectiveness of bridging from emergency to regular contraception: the Bridge-It study protocol. BMJ Open 2019;9:e029978. doi:10.1136/bmjopen-2019-029978
Cameron ST, Glasier A, McDaid L et al. Use of effective contraception following provision of the progestogen-only pill for women presenting to community pharmacies for emergency contraception (Bridge-It): a pragmatic cluster-randomised crossover trial. Lancet 2020; 396: 1585–94. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31785-2/fulltext
Cameron ST, Glasier A, McDaid L, Radley A, Patterson S, Baraitser P, et al. Provision of the progestogen-only pill by community pharmacies as bridging contraception for women receiving emergency contraception: the Bridge-it RCT. Health Technol Assess 2021;25(27) https://www.journalslibrary.nihr.ac.uk/hta/hta25270/#/abstract